Discerning Obamacare's rough beast

It was a strange experience Sunday night watching the lead-up and vote on HR-3590, the US House of Representatives name for the health care bill.

At this point, there have been so many twists and turns to the story, so many months of arguments and counterarguments and analyses and revisions, so many worst case scenarios promoted as truth — if we don't do something now, health care costs will bankrupt us all; if we pass this bill, the government will throw us out of the plans we love, and saddle our grandchildren with untenable debt — that it's hard to know what exactly what rough beast this might be that slouches toward our Bethlehem.

And I have to say, during the three hours I caught of 45-second, one- and two-minute speeches back and forth from Republicans and Democrats, I longed for the visceral dynamism and interaction of Question Time. The same themes, same stories rehearsed ad nauseaum, this was death by a thousand sound bites.

The Democrats had the better story, returning again and again to the idea that this bill was not about politics, but about sick kids and Grandma Alice and the poor folks down the street and your son that brave self-employed entrepreneur.

They praised the bill for ending insurance discrimination against those with preexisting conditions, for providing insurance for 32 million citizens who cannot currently afford it, and for its value to women, whose medical insurance tends to cost more. Said House Speaker Nancy Pelosi: 'After passing this bill, being a woman will no longer be a pre-existing condition.'

The Republicans, on the other hand, bemoaned the bill for not having listened to the people's concerns and, stealing a page from the Liberal Party's playbook, for the huge burden that it will place on future generations. (The struggles of the tens of millions Americans in the current generation who have little or no health care went unnoted.)

Republican opposition leader John Boehner began his comments, 'I arise with a sad and heavy heart', as though at a funeral, and spoke of how the Democrats had broken trust and strong-armed the deal, claims that seem unjustifiable from the facts, and yet certainly speak to the fears of a large segment of the US population.

He and his colleagues also attempted to position themselves as friends of the insurgent small-government, throw-the-incumbent-bastards-out Tea Party movement which has swept the country, cheering on the Tea Party protesters earlier in the day and repeatedly referring to the House of Representatives as 'The People's House'. (How pleased Mao Tse-Tung would have been to hear American Republicans using such a term.)

Listening to these alternatively utopian and apocalyptic visions of the post-bill future, I felt as though I was in a J. J. Abrams TV show, standing at the fissure between alternate universes with almost nothing in common. What does the Republican me look like, I wondered? (Probably thinner, damn him.) And how does he justify denying the kind of health care that he himself likely receives?

What little common ground remains at this point between Democrats and Republicans lies in the belief that this bill, for better or worse, represents one of the most consequential decisions in recent US history. Long time health care advocate Senator Ted Kennedy wrote in a brief letter before he died that 'health care is the great unfinished work of our society'. Pelosi quoted Kennedy, adding 'Until today'.

Whether that is true or not remains to be seen. After the bill passed Obama himself was more careful, saying this was a step in the right direction rather than the end of the line. His rhetorical attacks against insurance companies, while certainly speaking to the experience of many Americans, have been evaluated by some nonpartisan groups as less than the full picture. And the abiding law of unintended consequences has, if anything, more relevance to a bill of this size and complexity.

Still, for the moment our country's aspirations are clear — to be a place more giving to the sick and the needy, more welcoming to the stranger, more flexible for the creative and the entrepeneur — and to do so at the expense of those who can afford it. Of those who have been given much, much will be required.

Unlike the night of Obama's election, there was no cheering to be heard in the streets after the bill passed, no roars of joy, no celebrations. If there were any exclamations, they were probably sighs of relief.

But perhaps, as Obama said in his speech, 'This is what change (really) looks like.' Not elated but exhausted; not flashy but a grind; spin and arm-wrestling and point making and political compromise, yes, but in the end still a policy bespeaking what Lincoln called 'our better angels'.

We live in hope.

Jim McDermott SJ is an associate editor at America Magazine, the weekly review of the US Jesuits. He recently finished a seven month assignment in Australia.

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We could take leaf out of Obama's leadership style

..not elated but exhausted
..not flashy but a grind
..genuine debate and political compromise
..considering the good of the whole
..communicating the philosophy behind issues
..defining the issues
..engaging us in the debate

What this saga - thank heavens it ended well - shows us is how many Americans on the Republican right are dyed-in-the-wool, unreachable by reason, political idiots. It makes Obama's initial hopes for a different kind of American politics unachievable in his first presidential term. Maybe in his second?

Now the battle front moves back to the climate crisis. Obama should set aside the divisive ETS bill, it is moot after Copenhagen, and push for the alternative of an easy to introduce, simple to understand, fully reimbursable to citizens, national carbon-based fuel tax levied at the coalmine, wellhead or import port. He has alresdy announced renewal of government funding for research on nuclear energy, as part of a responsible decarbonisation energy policy mix. Decarbonisation reform will be as big and wearing a battle as health reform, but it must be done. Time and the increasing severity of climate change-related adverse weather events are on Obama's side. There will be more destructive winter storms and summer hurricanes.

With nuclear energy as part of his toolkit, I pray that Obama may get enough of Congress over the line on decarbonisation reform too. It is vital for the world's climate security that he achieves this. tony kevin | 24 March 2010

Just a short quote from God's Son (Mt.25:36 -40

"I was naked and you clothed me ,I was sick and you visited me ,I was in prison and you came to me ------------- (Truly I say to you as you did it to the least of these ,you di"d to me. David Sykes | 24 March 2010

I pray for President Obama, who has one of the most responsible jobs in the world .

Even though he is a most gifted man, he cannot do it alone.Bernie Introna | 24 March 2010

Wow! We've just seen off the breathtaking Winter Olympics, but no figure skater there has excelled Fr McDermott's exquisite dance around a smallish word that begins with A.Hugh | 25 March 2010

The Obama health legislation is the best plan at the present for the US. It is far from perfect but at least insurance companies cannot deny coverage for a preexisting condition. I wish all the measures came immediately into operation now rather than in 2014.
I am disappointed with Mr Obama for not aggressively pursuing the public health option which so many of us desired and caving into the health insurance lobby.
Anyway the Republicans, Fox network and their conservative minions campaigned very strongly to defeat Obama's health-care reform. To them I say, sour grapes.
I believe this is the first step on the long road to reforming the US health system, hopefully, to bring it into line with other western nations.
I am a US permanent resident who couldn't afford the ridiculous premiums offered by insurance companies. I needed life-saving surgery which ended costing me $38,000 for six days in hospital and am paying off the medical bill very slowly.
Whilst the Australian public system has its problems, it is much better than what we have in the US. Terry Steve | 30 March 2010